Nursing Elites

1. A nurse is assessing a patient with schizophrenia who is experiencing delusions. Which intervention is most appropriate?

• A. Agree with the patient's delusions to avoid confrontation.
• B. Encourage the patient to explore the basis of the delusions.
• C. Engage the patient in reality-based activities.
• D. Ask the patient to explain the delusions in detail.

Correct answer: C

Rationale: The most appropriate intervention when assessing a patient with schizophrenia experiencing delusions is to engage the patient in reality-based activities. This intervention helps distract the patient from the delusions and reorients them to the present, promoting grounding in reality. Choice A is incorrect because agreeing with delusions can reinforce them and hinder treatment. Choice B may exacerbate the delusions by delving deeper into their basis. Choice D may not be beneficial as it focuses solely on the delusions without addressing the need to ground the patient in reality.

2. A healthcare provider is assessing a client with suspected bipolar disorder. Which of the following findings should the healthcare provider expect? Select one that does not apply.

• A. Periods of elevated mood
• B. Decreased need for sleep
• C. Flight of ideas
• D. Anhedonia

Correct answer: D

Rationale: Findings in a client with bipolar disorder typically include periods of elevated mood, decreased need for sleep, and flight of ideas. Anhedonia, characterized by the inability to experience pleasure, is more commonly associated with major depressive disorder. Therefore, the healthcare provider should not expect anhedonia in a client with suspected bipolar disorder. The other choices are characteristic features of bipolar disorder, such as mania or hypomania.

3. Cognitive-behavioral therapy (CBT) is often used to treat which of the following conditions?

• A. Schizophrenia
• B. Bipolar disorder
• C. Posttraumatic stress disorder
• D. Generalized anxiety disorder

Correct answer: D

Rationale: Cognitive-behavioral therapy (CBT) is a widely used therapeutic approach effective in treating various mental health conditions. While CBT can be beneficial for different disorders, it is particularly well-suited for anxiety-related conditions like generalized anxiety disorder. CBT focuses on identifying and modifying negative thought patterns and behaviors contributing to anxiety, making it a suitable choice for treating generalized anxiety disorder. Therefore, the correct answer is D. Choices A, B, and C are incorrect because CBT is not typically the first-line treatment for schizophrenia, bipolar disorder, or posttraumatic stress disorder, although it may be used as a part of a comprehensive treatment plan.

4. A healthcare provider is assessing a client who has been diagnosed with conversion disorder. Which of the following findings should the provider expect?

• A. Paralysis of a limb
• B. Auditory hallucinations
• C. Dissociative amnesia
• D. Compulsive behaviors

Correct answer: A

Rationale: Conversion disorder is characterized by the development of neurological symptoms, such as paralysis of a limb, that cannot be explained by medical evaluation. The paralysis is typically due to a psychological conflict or stress rather than a physical issue. Auditory hallucinations, dissociative amnesia, and compulsive behaviors are not commonly associated with conversion disorder, making them incorrect choices. Therefore, the healthcare provider should expect to find paralysis of a limb in a client with conversion disorder.

5. A client with schizophrenia is experiencing auditory hallucinations. Which intervention should the nurse implement first?

• A. Ask the client to describe the content of the hallucinations.
• B. Instruct the client to ignore the hallucinations.
• C. Administer prescribed antipsychotic medication.
• D. Engage the client in reality-based activities.

Correct answer: A

Rationale: The initial intervention for a client experiencing auditory hallucinations, especially in schizophrenia, is to assess the content of the hallucinations. By asking the client to describe the hallucinations, the nurse can determine if they are command hallucinations that might pose a risk. This assessment is crucial in guiding further appropriate interventions to ensure the client's safety and well-being. Instructing the client to ignore the hallucinations (Choice B) may not be effective, as the hallucinations are real to the client. Administering antipsychotic medication (Choice C) may be necessary but should come after assessing the situation. Engaging the client in reality-based activities (Choice D) is important but not the first priority when dealing with auditory hallucinations.

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